FORWARD - Army Logistics University - U.S. Army

a. _______________________________________________________________________________
Course Title Length
________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
b. _______________________________________________________________________________
Course Title Length
________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
c. _______________________________________________________________________________
Course Title Length
________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
d. ________________________________________________________________________________
Course Title Length
________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
e. ________________________________________________________________________________
Course Title Length
_________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
f. _________________________________________________________________________________
Course Title Length
_________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
g. _________________________________________________________________________________
Course Title Length
__________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
h. _________________________________________________________________________________
Course Title Length
__________________________________________________________________________________
Dates Taken Given by (CPCE/ALMC, ECI, AFIT, etc.) Grade
Data Required by the Privacy Act of 1974 (5 U.S.C. 552a)
Title of Form: Application for Enrollment in CPCE Certificate Program
Prescribing Directive: CPCE (ALMC) SOP 621-7
Authority: 5 U.S.C. 301
Principal Purpose: To facilitate enrollment process of individuals in CPCE Certificate Program(s).
Routine Uses: Used to enroll individuals in the Certificate Programs. Information contained on an application
becomes a permanent
part of enrollee's record and serves as information document used by Certificate Evaluation Boards to
determine eligibility.
Mandatory or Voluntary Disclosure and Effect on Individual Not Providing Information: Voluntary delay of
enrollment in program.
187